Outcomes of submucosal(T1b) esophageal adenocarcinomas removed by endoscopic mucosal resection

查看全文 作　　者：Darren D [1]Ballard;Neel [2]Choksi;Jingmei [3]Lin;Eun-Young [4]Choi;B Joseph [5]Elmunzer;Henry [4]Appelman;Douglas K [6]Rex;Hala [6]Fatima;William [6]Kessler;John M [6]DeWitt

机构地区：[1]Division of Gastroenterology and Hepatology,Medical College of Wisconsin;[2]Division of Gastroenterology,University of Michigan;[3]Department of Pathology,Indiana University;[4]Department of Pathology,University of Michigan;[5]Division of Gastroenterology and Hepatology,University of South Carolina;[6]Division of Gastroenterology and Hepatology,Indiana University

出　　处：《World Journal of Gastrointestinal Endoscopy》索引2016年第8卷第20期,共7页

摘　　要：AIM To investigate the outcomes and recurrences of p T1 b esophageal adenocarcinoma(EAC) following endoscopic mucosal resection(EMR) and associated treatments.METHODS Patients undergoing EMR with pathologically confirmed T1 b EAC at two academic referral centers were retrospectively identified.Patients were divided into 4 groups based on treatment following EMR:Endoscopic therapy alone(group A),endoscopic therapy with either chemotherapy,radiation or both(group B),surgicalresection(group C) or no further treatment/lost to follow-up(<12 mo)(group D).Pathology specimens were reviewed by a central pathologist.Follow-up data was obtained from the academic centers,primary care physicians and/or referring physicians.Univariate analysis was performed to identify factors predicting recurrence of EAC.RESULTS Fifty-three patients with T1 b EAC underwent EMR,of which 32(60%) had adequate follow-up ≥ 12 mo(median 34 mo,range 12-103).There were 16 patients in group A,9 in group B,7 in group C and 21 in group D.Median follow-up in groups A to C was 34 mo(range 12-103).Recurrent EAC developed overall in 9 patients(28%) including 6(38%) in group A(median:21 mo,range:6-73),1(11%) in group B(median:30 mo,range:30-30) and 2(29%) in group C(median 21 mo,range:7-35.Six of 9 recurrences were local;of the 6 recurrences,5 were treated with endoscopy alone.No predictors of recurrence of EAC were identified.CONCLUSION Endoscopic therapy of T1 b EAC may be a reasonable strategy for a subset of patients including those either refusing or medically unfit for esophagectomy. 关键词：ESOPHAGEAL cancer SUBMUCOSAL T1b Endoscopic MUCOSAL RESECTION Chemotherapy ESOPHAGECTOMY

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Outcomes of submucosal(T1b) esophageal adenocarcinomas removed by endoscopic mucosal resection

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